Organization
CITY OF ST. JOSEPH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA BRADLEY MSW (DIRECTOR OF HEALTH)
(816) 217-4636
Entity
Organization
Contact information
Practice address
904 S 10TH ST, SAINT JOSEPH, MO 64503-2405
(816) 271-4636
(816) 271-4764
Mailing address
904 S 10TH ST, SAINT JOSEPH, MO 64503-2405
(816) 271-4636
(816) 271-4764
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23691018
MC PLUS WITH BC BS
MO
Enumeration date
03/19/2007
Last updated
08/10/2023
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